Dry mouth

Dry mouth is uncomfortable. If too little saliva flows, harmful germs multiply. A sip of water often helps. But there are also pathological causes.

Main reasons for dry mouth

The show contestant reaches for the glass of water next to him. Before every new question. He’s excited, his mouth is dry, his voice is hoarse. He feels a lump in his throat and has sweaty hands. What he needs now are a few deep breaths and – something to drink. So that the vocal cords become supple, so that the tongue does not stick to the roof of the mouth and so that the correct answer flows smoothly over the lips.

– Mouth breathing, nervousness, body movements

Those who are nervous, tense or anxious often have a dry mouth. Speakers know that. It’s not just stage fright, long speaking also dries out the mucous membranes. The air that flows in through the mouth removes moisture from them. Breathing through the mouth is a major cause of dry mouth. If the air in a room is also warm and dusty, the desire to have a drink quickly arises in order to moisten the mouth and throat again.

Saliva production naturally decreases at night. As a result, many people experience a sticky, dry mouth and bad breath in the morning. Because one favours the other. Snoring with your mouth open increases the lack of moisture. But alcohol in the evening and a spicy dish also help when the throat is parched after waking up.

When we have a cold, we breathe more through our mouths. The throat becomes dry and scratchy. Then it often helps to moisten the blocked nose, for example by inhaling or using saline nasal sprays to get better air again and to drink a lot.

– When there is a lack of liquid and moisture

Drink water
Against moisture loss: Do not forget to drink in the heat and during exercise

In addition to mouth breathing, a lack of fluids is one of the main causes of dryness in the mouth. People who generally drink too little also produce too little saliva during the day. Especially in older people, this is often the reason for discomfort when chewing, swallowing and speaking.

Hunger phases also change the metabolism, as a result of which the mouth becomes dry. Then it is no longer enough to only consume liquids. Deficiencies or eating disorders have a noticeable effect on the salivary glands and mucous membranes.

Heavy sweating and high outside temperatures draw moisture out of the body. Another important reason for a sore throat and damaged mouth is smoking. Then the discomfort in the mouth is not only temporary but permanent. And besides dental problems, they cause other far-reaching damage.

Fever and many infections, especially gastrointestinal infections, can sometimes dangerously dry the body. A dry mouth is just a sign of it. Drinking a lot is then an important first step.

– Medicines and therapeutic measures

Another common cause of dry mouth is medication. Various drugs influence certain glandular functions via nerves and hormones, including the salivary glands. Among other things, agents that act on the autonomic nervous system are active in this direction. These include certain eye medications, anti-bladder medications, antidepressants, some medications for an irregular heartbeat or high blood pressure, sleeping pills, and others. Older people often take several drugs at the same time. This is one of the reasons why dry mouth occurs more often in old age.

Surgical interventions in the head area can sometimes affect the salivary glands. Chemotherapy and radiation for the treatment of cancer also often affect the production of saliva in the mouth. A dry mouth can also be an expression of acute or serious health problems.

Diseases that can lead to dry mouth

First and foremost are dental diseases and inflammations in the mouth, such as inflammation of the oral mucosa. Diseases of the mouth or head salivary glands play an important role. Inflammation, swelling, injuries and tumors can hinder their function and thus the flow of saliva.

Dry mouth is a key symptom of the so-called Sjogren’s syndrome. This autoimmune disease mainly affects the salivary and lacrimal glands. Metabolic disorders and hormonal diseases, such as diabetes mellitus, often also affect the salivary glands. Certain nerve damage also affects the formation of saliva in the glands. Some mental illnesses influence the degree of moisture in the mouth via the nerves.

A dry mouth also sets in with severe infectious diseases, for example often in the course of an AIDS disease. Occasionally, poisoning that occurs suddenly or is gradual can be a possible trigger. In addition to visual disturbances, nausea and vomiting, dry mouth is one of the warning signs of botulism, a dangerous but now rare food poisoning.

The saliva: moisturizer and cleaning power

The large parotid glands
The large parotid glands: parotid gland, mandibular salivary gland, sublingual salivary gland (a click on the magnifying glass shows the whole picture)
© W & B / Jörg Kühn

In the oral cavity, the three large and numerous small salivary glands produce between half and one and a half litres of saliva every day. The three big ones are the parotid, mandibular and sublingual salivary glands. To be on the safe side, they are on both sides of the head. The saliva washes away not only leftover food but also all kinds of germs, such as bacteria, fungi, viruses and tissue particles. With it, we constantly clean the entire mouth area and keep the mouth moist. This makes it easier to speak and swallow. The saliva helps digest the food, make it lubricious and, in a first step, break it down. It also protects the teeth from aggressive bacteria that, in combination with sugar, lead to tooth decay.

If the salivary glands produce too little saliva, the mouth becomes dry, often burns and is more susceptible to disease. Harmful bacteria are rampant. Bad breath and dental problems set in. It is more difficult to speak, chew, and swallow. Other consequences can include hoarseness, frequent coughs, indigestion and heartburn. Dry nasal mucous membranes, dry eyes and rough skin areas are also possible.

In order for sufficient saliva to flow, the salivary glands must be well supplied with blood and healthy, and the oral mucous membranes must be intact. The autonomic nervous system with its two components, the sympathetic and the parasympathetic nerve cords, has a significant influence on the function of the salivary glands. For once, both work together here, but the parasympathetic nervous system is in charge. For example, drugs that inhibit the parasympathetic nervous system can lead to dry mouth. Nerve diseases and tumors in the course of the responsible nerve fibres also interfere with the production of saliva.

The metabolism and the water-salt balance in the glands are also important for the flow of saliva. This explains why metabolic and hormonal disorders are sometimes associated with dry mouth.

The formation of saliva is stimulated by adequate fluid intake and also by good chewing. Anyone who chews poorly, for example, because of an inflammation of the mouth or a badly fitting denture, often also suffers from dry mouth, which in turn makes chewing difficult.

Dry mouth: when to see a doctor?

Dry mouth and constant bad breath
Dry mouth and constant bad breath: now the doctor is called for
© Thinkstock / PhotoDisc

Always talk to your doctor if you have a feeling of dryness in your mouth that cannot be explained by temporary influences. A particular reason to see a doctor is if:

  • the mouth is dry for a long time or repeatedly,
  • the dry mouth is very pronounced and is starting to cause you problems, for example speaking, chewing or swallowing,
  • the mouth feels dry since taking a certain medicine
  • You are under stress or emotional distress and experience increased dryness in your mouth,
  • your mouth suddenly becomes dry, you feel really sick, and you have visual disturbances, nausea and vomiting.
  • together with the dry mouth, other symptoms occur in the mouth area, for example, strong bad breath, burning tongue, pain in the oropharynx, numbness in the mouth, bleeding from the mouth, hoarseness, throat irritation and loss of taste,
  • symptoms of illness such as burning, dry eyes, dry nasal mucosa, frequent urination, increased thirst, heartburn, joint pain, headache are associated with a dry mouth.

Depending on the suspicion, the doctor may call in a specialist. In the case of diseases of the mouth, nose and throat and the salivary glands, this is usually an ear, nose and throat doctor. A specialist in internal diseases (internist) is often responsible for other areas, including a specialist in rheumatic diseases (rheumatologist), hormone disorders (endocrinologist) or nerve diseases (neurologist). In the case of dental problems or poorly fitted prostheses, the dentist is of course asked.

Overview of possible causes of dry mouth

Dry mouth
Dry mouth – common causes in everyday life: talking all day, drinking too little, being tense
© Ingram / RYF

– Habits of life, everyday stresses

  • Drinking too little: Drinking too little can have consequences in many areas of the body. Mucous membranes and skin dry out and the water-salt balance can become unbalanced. A sufficient supply of fluids moisturizes the mouth and keeps the internal balance of the body stable. This is also important for saliva production.
  • Dry, dusty air, heat: Overheated, dusty rooms, too little humidity dry out the entire oral cavity. Hoarseness and throat irritation are often added. The heat of the sun and sweating remove moisture from the body. This can also be felt in the mouth.
  • Spicy dishes: The ingredients of plants such as chilli or hot peppers irritate the oral mucous membranes. The mouth, tongue and throat burn and feel dry.
  • Alcohol: If the body breaks down alcohol at night, a parched oral cavity and throat are typical withdrawal symptoms. Severe thirst, headache, and nausea are other signs. Permanently high alcohol consumption can lead to severe metabolic problems and diseases of the oropharynx, for example, cancer.
  • Smoking: Particles from tobacco smoke stick to the oral mucosa, the mouth dries out. Smoking constricts the blood vessels and worsens all blood circulation. This affects the formation of saliva in the mouth and increases the risk of disease in the nasopharynx. This increases the dry mouth even more.
  • Excitement, stress: in phases of increased tension, the body reacts according to age-old patterns. Nerve activities, hormone levels and metabolism change. The heart beats faster, the muscles are tightened, the blood vessels are narrowed. Breathing also speeds up. We often draw in more air through our mouths when we are nervous. The throat becomes dry, the vocal cords are tense. If there is no relaxation, various physical and psychological problems can arise.
  • Snoring: The saw noises, which usually keep the person next to you awake at night, often do not bother the snorer themselves, but often lead to an increased dry mouth. Daytime tiredness and concentration problems are further signs that sleep is disturbed. Snoring can be detrimental to health in many ways. This is particularly true for sleep apnea syndrome.

– Diseases of the mouth and nasopharynx

tongue burns
The tongue burns, the mouth is dry: this could be due to an inflammation of the mucous membrane
© Thinkstock / Stockbyte
  • Oral mucosal inflammation: Triggers are infections caused by bacteria, viruses and fungi. People who already have a dry mouth and damaged oral mucosa, for example, because they smoke, drink a lot of alcohol, suffer from an eating disorder or their immune system is weakened, are particularly susceptible to this. In addition, those affected often avoid chewing well because of the discomfort in the mouth. This also inhibits the formation of saliva.
    Symptoms: The mouth is dry, it burns and hurts. In addition, there are problems with swallowing, bad breath, redness, swelling and sometimes bloody spots. A pronounced feeling of illness is possible. An infestation with Candida yeast fungi ( oral thrush) indicates light, whitish coatings, an infection with herpes viruses, painful blisters in the mouth and fever.
  • Dental diseases: Sometimes inflammation of the gums (gingivitis) and the tooth-supporting structures (periodontitis) affect the oral mucosa. This also applies to ill-fitting dentures. In the case of dental problems, chewing and thus the activity of the salivary glands can also be impaired.
    Symptoms are bleeding gums, bad breath, toothache, especially sensitivity to cold and sweet things, and sometimes a dry mouth.
  • Chronic sinus infections: As with a common cold, breathing through the nose is impeded. The increased mouth breathing often makes the mouth dry.
    Symptoms of chronic sinusitis can include repeated headaches, difficult nasal breathing, dry nasal mucous membranes and, at the same time, backflow of mucus into the throat. Those affected have to cough frequently and smell less well.
    Burning tongue or burning mouth syndrome: The causes of these far-reaching symptoms in the mouth include fungal infections, allergic reactions, problems with dentures and deficiency symptoms, such as a deficiency in B vitamins, or hormonal changes, for example during menopause. Psychological stress can also be a trigger.
    Symptoms: Burning and pain on the tongue and often in wider areas of the mouth, sometimes a dry mouth and taste disturbances.
  • Hunter glossitis: This inflammation of the tongue can occur with a vitamin B deficiency and anemia.
    Symptoms: In addition to the common symptoms of anemia, such as paleness, tiredness, and a feeling of weakness, there are also burning and pain in the tongue, dry mouth and taste problems. The tongue looks smooth and greyish-red.

– diseases of the salivary glands

Dry mouth, swelling around the neck and behind the ears
Dry mouth, swelling around the neck and behind the ears: the salivary glands may be affected
© Fotolia / ArTo

In addition to viruses (mumps virus, for example), bacteria can lead to inflammation of the parotid gland and other head salivary glands. Other triggers for inflammatory processes are disorders in the immune system or radiation therapy. Sometimes non-inflammatory swellings, injuries or tumors of the salivary glands cause disturbances in the formation of saliva.

  • Acute salivary gland inflammation: Dry mouth is the main cause of acute bacterial infections. However, people who eat poorly, drink too little, are emaciated and therefore have too little protective salivation are more susceptible to this. The causes of inflammation are sometimes dental problems or salivary stones. These are deposits in the ducts and in the tissues of the salivary glands.
    Symptoms: The diseased gland is swollen, painful and maybe reddened, sometimes pus oozes out. The sick often have a fever and find it difficult to open their jaws. The formation of saliva decreases and the mouth becomes drier.
  • Chronic salivary gland inflammation: Some chronic infections, for example in the context of AIDS , are accompanied by a dry mouth.
    Symptoms: The glands are repeatedly swollen, on one or both sides. The saliva in the mouth changes, it can taste salty, increasing dryness is possible.
  • Radiation sialadenitis: Sialadenitis is the medical term for inflammation of the salivary glands. A radiation therapy of head and neck tumors can damage the salivary glands. They become inflamed and make less saliva. Stubborn, sometimes even permanent dry mouth, loss of taste, burning tongue, frequent thrush are the consequences.
  • Head salivary glands swollen on both sides (sialadenosis): Usually, it is the parotid glands that swell without there being any inflammation. The saliva production is disturbed. Doctors assume that the nerve fibers of the autonomic nervous system that control the salivary glands are damaged. The causes for this can be varied, but sometimes also not ascertainable. Metabolic problems due to alcohol addiction, deficiency symptoms in eating disorders or celiac disease, hormonal disorders in menopause, thyroid disease and diabetes mellitus or drug effects are among other things possible triggers.
    Symptoms: Usually the two parotid glands, sometimes also the sublingual glands or the lower jaw glands, are swollen without pain. The flow of saliva decreases, the mouth is dry.
  • Injuries: Sometimes the parotid gland is affected by direct damage. It is not uncommon for injuries to affect the facial nerve. The symptoms vary depending on the type of injury. Bleeding and pain may occur. Saliva formation is usually hindered and the mouth is dry as a result. Facial paralysis is possible.
    Occasionally, rare malformations of the salivary glands resulting in reduced salivation and dry mouth. Constrictions and obstacles in the gland ducts are also sometimes caused by a tumor.
  • Salivary gland tumours: A typical sign of a benign growth is usually a painless swollen gland with no further symptoms. The much rarer malignant forms cause different symptoms, depending on how quickly and where the tumor is spreading. Possible symptoms are pain, swollen lymph nodes and facial paralysis. Cancer development can sometimes also affect saliva production. You experience dry mouth or, more often, excessive salivation.

– Autoimmune disease: Sjogren’s syndrome

A dry mouth is one of the leading symptoms of Sjogren’s syndrome. It is the second most common autoimmune disease after rheumatoid arthritis. Autoimmune means that misdirected defence reactions attack the body’s own structures. In Sjogren’s syndrome, they are directed against the salivary and lacrimal glands. These become chronically inflamed. The disease can develop as a result of rheumatoid arthritis, connective tissue disease, or inflammation of the liver (hepatitis B or C). However, it also occurs for no apparent cause. With this primary form, joints and lymph nodes are also often affected.

Symptoms: The production of saliva and tears decreases more and more, mouth and eyes dry out (sicca syndrome). The eyes often sting, and there is also a feeling of pressure and foreign bodies. The sick have difficulty swallowing and breathing, as the mucous membranes in the nose, in the airways and in the esophagus also become dry. Other possible consequences are cough, hoarseness, frequent pneumonia and esophagus infections, and dental diseases. The lymph nodes can swell and the joints are often painful due to the inflammation of the joints. Possible secondary diseases are allergies, gluten intolerance (celiac disease) or kidney damage.

– Medication

Medication for old age
Medication for old age: some could be the cause of dry mouth
© Jupiter Images GmbH / Creatas

Dry mouth is a side effect of a number of medicines. On the one hand, there are drugs that affect nerve activities in the brain and head area. The focus is on the autonomic nervous system with its two parts, the sympathetic and the parasympathetic. It regulates the amount of saliva in a decisive way. But higher-level nerve impulses also play a role via a variety of connections. Other drugs, on the other hand, change the metabolism, including in the head salivary glands. This can result in swelling and impaired saliva formation. Medications that can cause dry mouth include:

  • Psychotropic drugs: These include in particular drugs against depression (antidepressants) and drugs against psychoses, anxiety and other psychological disorders (neuroleptics). Among the antidepressants, the tricyclic antidepressants play a role, but also some serotonin reuptake inhibitors (SSRI) and certain serotonin norepinephrine reuptake inhibitors (SNRI). A remedy from this group, duloxetine, is used, for example, alongside other drugs as a drug against bladder weakness in women or in painful diabetic nerve disorders.
  • Anticholinergics: These drugs affect the parasympathetic part of the autonomic nervous system. Dry mouth is a common side effect. Atropine is one of the anticholinergics. In the form of eye drops, it dilates the pupils. In addition to other drugs, it is also listed as a drug for the induction of anesthesia but now plays a subordinate role here. Doctors use other anticholinergics as a remedy for bladder weakness, sometimes as a short-term bypassing a heartbeat that is too slow, as anticonvulsant medication or asthma medication. Neurologists also sometimes use anticholinergic substances in the treatment of Parkinson’s disease.
  • Sleep pills, tranquillizers: Certain sleep pills cause a dry mouth, which is sometimes used for short periods of severe sleep disorders. These include certain substances from the group of so-called antihistamines, some of which are available without a prescription and can also be effective as a remedy for nausea and vomiting.
    Benzodiazepines also sometimes cause dry mouth. Doctors prescribe these strong sedatives specifically for anxiety disorders or in the treatment of epilepsy, among other things.
  • Painkillers: Strong painkillers from the opioid group, as well as the cough and pain reliever codeine, often have dry mouth as a side effect.
  • Antibiotics: Here it is primarily penicillins that can lead to dry mouth.
  • Heart and high blood pressure drugs: Quite a few of them trigger a feeling of dryness in the mouth. These include some diuretics (water and salt washouts), ACE inhibitors, beta blockers, and calcium channel blockers.
  • Chemotherapy drugs: Cancer patients very often suffer from dry mouth. In addition to radiation therapy in the head area, substances used for chemotherapy often attack the oral mucosa. Inflammation and impaired salivation are possible consequences. Accompanying treatment measures help to alleviate the inflammation and keep the mouth moist.
  • Other medication: So-called central anti-sympathotonics often cause dry mouth. Active ingredients from this group are sometimes used as additional drugs in glaucoma treatment, as alcohol withdrawal agents and occasionally as high blood pressure agents. Muscle relaxers, some other Parkinson’s drugs, and certain anti-epileptic drugs can also trigger dry mouth.

If you have the impression that your mouth is noticeably drier since taking a particular medication, talk to your doctor about it. If necessary, he can change the medication or adjust the dosage. Often, however, measures that stimulate the flow of saliva are sufficient. Do not stop taking any medicine on your own and do not change the dose on your own.

– Mental illness

Overcome fears
Overcome fears with behavioral therapy
© iStock / endopack

Pathological mental disorders often affect the autonomic nervous system. This regulates the largely involuntary life processes in the body such as digestion, the formation of sweat, saliva and tear fluid, heart activity, blood pressure, breathing, sexuality and much more. A mental illness also changes other nerve activities in the brain and dependent hormone functions. In many clinical pictures, in addition to the emotional and mental symptoms, there are pronounced physical complaints. Dry mouth is often one of them.

  • Anxiety disorders: Excitement and anxiety in everyday life often cause a dry mouth via the autonomic nervous system and other influences. In anxiety disorders, anxious tension and feelings of panic dominate more or less pronouncedly the whole of life. The mental and physical symptoms are varied. Dry mouth can recur, especially during a panic attack. Read more about pathological fears in the guide “Anxiety and Anxiety Disorders”.
  • Depression: A depressive illness often shows itself in very different symptoms. Physical complaints accompany emotional and spiritual changes. They can affect many organ functions. Dry mouth, along with burning tongue, loss of taste, visual disturbances, hearing problems, headaches and dizziness are possible symptoms in the head area.
  • Eating disorders: The various forms of disrupted eating behaviour are based on profound emotional problems. The health consequences of anorexia or bulimia, for example, are serious. With anorexia, life-threatening weight loss is in the foreground. People with bulimia try to counteract food cravings with self-induced vomiting.
    Pronounced deficiencies bring the entire metabolism out of balance in both clinical pictures. The salt-water balance shifts, vitamin deficiencies and gastrointestinal problems set in. The balance of nerves and hormones is permanently disturbed. This can be seen, for example, in the absence of a menstrual period in many anorexic women. Dry mouth is just one possible physical symptom among many.

– Metabolic and hormonal diseases

Measuring blood sugar
Measuring blood sugar in diabetes mellitus: having the values ​​under control with regular checks and preventing consequential damage

A disturbed water-salt balance, which leads to symptoms of dehydration, is one of the main causes of dry mouth. However, other metabolic problems can also affect the salivary glands and the flow of saliva.

  • Diabetes mellitus: As blood sugar levels rise, the metabolism derails. The body excretes more sugar in the urine. As a result, we lose water and minerals. The symptoms of diabetes often include frequent urination and severe thirst. People feel tired and exhausted and lose weight. Dry mouth can occur as a result of the loss of fluid, later also in addition to other symptoms as a result of metabolic changes and possible kidney and nerve damage.
    Diabetes insipidus: Excessive thirst, constant drinking and increased urination, including at night, are the characteristic symptoms of this hormone disorder. Incidentally, it has nothing to do with diabetes mellitus. The disorder affects the kidneys and changes the composition of the urine. The causes of diabetes insipidus often lie in the brain, namely in the pituitary gland. For various, often unknown reasons, it does not produce enough of a certain tax hormone. It is also possible that the kidneys themselves no longer respond properly to the hormone.
  • Dehydration from infection and heat damage: If the body loses more fluids than it absorbs, it can become dehydrated. This is especially possible with intestinal infections that are accompanied by vomiting, diarrhea and fever. An uncomfortably dry mouth is often an added factor.
    Heavy blood loss also causes dehydration. Extreme heat, for example, if someone is exposed to intense sunlight for too long, also removes water and salts (electrolytes) from the body. A disturbed electrolyte balance also changes numerous nerve impulses and affects the nerve cells in the brain.
    Symptoms: Dry mouth is only a consequence. The focus is on complaints such as headaches, turning black, dropping blood pressure and racing heart. Affected people feel weak, dizzy, and are often mentally confused.

– disorders in the nervous system

Damage to the nerve fibers of the autonomic nervous system can affect the formation of saliva in the mouth. They arise, for example, from injuries, the consequences of operations, radiation or tumors. Infections and inflammatory changes also play a role. This can happen especially after an HIV infection. Dry mucous membranes with a dry mouth are a common problem for AIDS sufferers.

  • Botulism: The bacterium Clostridium botulinum develops mainly in contaminated food, especially in canned food and vacuum packaging. Sometimes it also forms in wounds. It contains a neurotoxin that causes nausea, vomiting, diarrhea and eventually paralysis in the eye area with visual disturbances, dry eyes, dry mouth and difficulty swallowing. Food poisoning by the botulism pathogen has become rarer thanks to improved hygiene.
  • Lambert-Eaton Syndrome: Dry mouth is a very common symptom of this autoimmune disease. Here the body’s own defences prevent the transmission of nerve impulses, especially in the case of vegetative nerves. Lambert-Eaton syndrome can result from cancer, primarily lung cancer. It can also develop in the context of other autoimmune diseases, such as inflammation of the thyroid gland or a certain form of anemia called pernicious anemia.
    Symptomsdry mouth, dry eyes, muscle weakness especially in the pelvic area and legs, which improves when the affected person moves the muscles. tingle, Drop in blood pressure when standing, problems swallowing, blurred vision and impotence are other possible symptoms.

Diagnosis: How the doctor deals with a dry mouth

the doctor first examines the oral cavity
On the trail of dry mouth: the doctor first examines the oral cavity
© F1online / MedicalCheckUp

The first point of contact is usually the family doctor. At the beginning of the examination, he will inquire in detail how the dry mouth has manifested itself, since when it has existed, whether the feeling of dryness is constant or recurs at intervals and what other symptoms you have. It is also important for the doctor to know how much you drink every day, whether you have problems sleeping, for example snoring heavily, and whether you are emotionally stressed. Other aspects are smoking and increased alcohol consumption. As a rule, the family doctor knows your underlying illnesses and the corresponding therapies. Let him know if something has changed physically here or if you have received a new diagnosis from another doctor that is unknown to him.

The physical exam follows. The doctor often recognizes typical signs of dryness in the oropharynx. Mucous membranes and tongue can be changed, redness and inflammation spots can be visible. The doctor looks at the areas of the head salivary glands, checks whether there is any external swelling on the neck and head area, looks at the eyes. He also receives clues from the mobility of the facial muscles.

Depending on the suspicion, doctors also measure saliva flow and saliva production (sialometry) using simple methods. For example, by chewing a medicinal wax ball, the patient stimulates the flow of saliva and spits the amount obtained into a special measuring vessel. With the Saxon test, the patient puts a cotton ball in their mouth for about two minutes, which the doctor then weighs. Such tests are usually used by specialists in internal medicine (internists) when they diagnose Sjögren’s syndrome, and they also use ear, nose and throat doctors.

Initial blood and urine tests can indicate inflammation and metabolic disorders. Depending on the suspicion, the family doctor will call in a specialist.

The ear, nose and throat doctor examines the entire mouth, nose and throat area and the salivary glands. This is usually followed by an ultrasound examination, especially of the salivary glands. Here, the ENT doctor can often reveal significant changes. Magnetic resonance imaging or salivary gland scintigraphy are sometimes indicated.

A sialoendoscopy makes it possible to view the gland ducts through which the saliva exits with a special tube (endoscope). Sometimes an endoscopy of the nasal cavity is also indicated to check for chronic inflammation and changes in the mucous membrane. If the doctor notices significant swelling of the salivary glands, he often takes tissue samples (biopsy) for a fine-tissue examination, for example, if a tumour or Sjögren’s syndrome is suspected.

Specialized internists are usually responsible for diagnosing and treating autoimmune diseases such as Sjögren’s syndrome as well as metabolic and hormonal disorders. This can be a rheumatologist, a hormone specialist (endocrinologist) or a diabetologist. Extended blood and urine tests in the laboratory, hormone tests and imaging procedures often confirm the respective diagnosis. In order to diagnose Sjogren’s syndrome, ophthalmological examinations are also important.

A neurologist diagnoses disorders of the nervous system. He uses various test procedures to check damage to the vegetative nerve fibers. Imaging procedures sometimes help to clarify the location and cause of a disorder. In rare cases, an examination of the nerve fluid may be indicated.

Psychiatrists and psychotherapists uncover psychological disorders with detailed discussions and special tests. Occasionally, a stay in a special clinic is indicated here, for example in the case of eating disorders.

Therapy: treat illnesses, keep your mouth moist

Care for teeth and oral cavity every day: This is very important if your mouth is dry

Therapy is always based on the diagnosis first. Treating a pathological cause often also improves the dry mouth.

A therapy often includes measures that help to stimulate the flow of saliva. Here are some examples:

  • It is usually important to drink a lot. However, discuss with your doctor what amount is right for you, especially if you have heart, liver, or kidney disease. Suitable drinks are mineral water, herbal teas without sugar or juice spritzers that do not contain too much acid. It is often good to drink small sips throughout the day.
  • Chewing gum and sucking sugar-free sweets also support saliva formation.
  • Make sure that the humidity in your rooms is sufficiently high.
  • Avoid spicy or heavily salted foods. They irritate the oral mucous membranes and deprive them of moisture. Hard bread crusts or pieces of baked goods sometimes rub the palate. As a result, the mouth burns and hurts even more. Coffee and alcohol also increase dryness in the mouth. It is best to eat a balanced diet with plenty of vegetables and fruits.
  • Most importantly: quit smoking.
  • Good oral hygiene prevents inflammation. Take good care of your teeth. In addition, have your teeth checked regularly by the dentist in order to get a grip on possible tooth damage caused by a pathologically dry mouth in good time

If the dryness in the mouth is very pronounced and stressful, special lozenges or drugs that promote saliva production can be useful. Extra solutions for rinsing moisten the oral cavity. There are also saliva substitutes. Doctors sometimes use artificial saliva for Sjogren’s syndrome or dry mouth caused by chemotherapy and radiation therapy.

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